DREAM Study May Be Misleading

It’s no question that Omega-3s have many health benefits. They’re good for heart, joint, and muscle health, but a recent study has put their benefits for eye health into question. Published on April 13 in the New England Journal of Medicine, the N-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease study states that participants taking Omega-3s did NOT have significantly better outcomes than the placebo. While this is true, this negative conclusion is an overstatement.

Don’t Draw Conclusions from Headlines

Many of the articles that cover this study have negative headlines and titles. Most hang on the conclusion, saying that omegas weren’t effective. If you look at the results, the participants’ Ocular Surface Disease Index (OSDI) scores in the Omega-3 group significantly improved by the end of the trial. The conclusion should specify that the fatty acid improvements weren’t statistically significant compared to the placebo.

About the Study Placebo

The DREAM study used olive oil as the placebo. One definition of a placebo is “a substance that has no therapeutic effect, used as a control in testing new drugs.” Olive oil contains phytochemicals that have proven health benefits, or “therapeutic effect.” It’s also an important staple in a Mediterranean diet, which has been shown to reduce the risk of late stage age-related macular degeneration (AMD) by 50%.

A “Real-World” Study

The study participants continued using other forms of relief throughout the course of the trial, including:

Artificial tears

Cyclosporine drops

Warm lid soaks

Lid scrubs or baby shampoo

Additional Omega-3 supplementation (up to 1100 mg)

Including these management options blurs the line of what was effective during the study and what wasn’t. To directly correlate Omega-3s with relief, patients should only supplement with those specific fatty acids.

ONIT vs. DREAM

EyePromise® believes that patients with occasional dry eye need more than Omega-3s but ignoring the many studies that prove they have a positive impact on eye health would be a miss. The Ocular Nutrition Impact on Tear Film (ONIT) Study utilized EyePromise EZ Tears™ and showed greater improvements for four of the measurements included in the DREAM study after one month. These measurements include:

OSDI

40% improvement after 1 month with ONIT

31% improvement averaged between 6-12 months during DREAM

Conjunctival Staining

28% improvement after 1 month with ONIT

13% improvement averaged between 6-12 months during DREAM

Corneal Staining

41% improvement after 1 month with ONIT

15% improvement averaged between 6-12 months during DREAM

TBUT

27% improvement after 1 month with ONIT

23% improvement averaged between 6-12 months during DREAM

Practitioners shouldn’t ignore the science, but consider looking beyond the headlines and diving in to the real results of scientific studies. Having an active placebo like olive oil and involving other remedies doesn’t give a clear indication of the direct effectiveness of Omega-3s. This study shouldn’t be used as a definitive conclusion, but as a springboard for further research into the ability of Omega-3s to relieve occasional dry eye.